ObjectiveThrough qualitatively and quantitatively analysis of the differences in chemical composition between the combined decoction and single decoction of Huaganjian and comparison of their core efficacy， to explore the rationality of the flexible clinical application of Huaganjian compound preparations and single-flavored dispensing granules. MethodsUltra performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS） was used to qualitatively analyze the combined decoction and single decoction samples of Huaganjian， and meanwhile， the contents of four index components（geniposide， paeoniflorin， hesperidin and paeonol） were quantitatively analyzed by high performance liquid chromatography（HPLC）. Nonalcoholic fatty liver disease（NAFLD） rat model induced by high-fat diet was applied to compare the efficacy of combined decoction and single decoction of Huaganjian. A total of 30 male SD rats were randomly divided into the control group， model group， lovastatin group（1.8 mg·kg^-1）， combined decoction group（1.26 g·kg^-1） and single decoction group（1.18 g·kg^-1）. After successful modeling， lovastatin group， combined decoction group and single decoction group were given corresponding doses of drugs by intragastric administration every day， and the control group and model group were given equal amounts of normal saline by intragastric administration， after 4 weeks of administration， the serum and liver tissues were collected， and the contents of alanine aminotransferase（ALT）， aspartate aminotransferase（AST）， total cholesterol（TC）， triglyceride（TG）， low-density lipoprotein cholesterol（LDL-C） and high-density lipoprotein cholesterol（HDL-C） in serum of rats were detected， and the liver pathological examination was carried out by hematoxylin-eosin（HE） staining and oil red O staining， so as to compare differences of their efficacy. ResultsSeventy chemical components were initially identified and attributed from the lyophilized powder of the combined decoction and single decoction samples of Huaganjian， and there was no obvious difference in composition between the two. Further quantitative analysis showed that the contents of geniposide， paeoniflorin， hesperidin and paeonol in the combined decoction samples were significantly increased when compared with those of the single decoction samples（P<0.01）. The pharmacodynamic results showed that compared with the model group， both the combined and single decoction groups of Huaganjian could improve the liver index of NAFLD rats， reduce the serum levels of AST， ALT， TC， TG and LDL-C， increase the serum level of HDL-C， and ameliorate the pathological changes of liver cell steatosis and fat accumulation. However， there was no significant difference in pharmacodynamic effects between the combined decoction group and the single decoction group. ConclusionThere is no significant difference between the combined decoction and single decoction of Huaganjian in terms of chemical composition， but the contents of the four index components show significantly difference. Both of them can significantly improve the fat accumulation and liver function in NAFLD rats. This study provides a reference basis for the rational clinical application and evaluation of famous classical formula compound preparations and single-flavored dispensing granules.

Objective:To investigate the construction status of clinical skills training centers of secondary and above comprehensive western hospitals in Yunnan Province, and to provide a basis for the scientific, specific and standardized construction and development of clinical skills training centers of hospitals at all levels in Yunnan Province.Methods:The evaluation index of the construction of clinical skills training center was established, and questionnaires were developed to investigate the current situation of the construction of clinical skills training center in the secondary and above comprehensive western hospitals in the whole province. SPSS 17.0 software was used for chi-square test.Results:According to the investigation, 79.1% (72/91) of secondary and above comprehensive western hospitals in Yunnan Province have established clinical skills centers of different scales, but 84.6% (77/91) of them have fewer than 50 teachers participating in clinical skills teaching each year, with weak faculty and big differences in the faculty of hospitals at all levels ( P<0.05). In 64.6% (84/130) of the centers, the simulated teaching courses are only single basic skill courses, and the training content is relatively single, with great differences in the current situation ( P<0.05). Only 33.0% (30/91) of the centers have initially established an internal quality control system, and there are statistically significant differences in the way of conducting quality evaluation ( P=0.023). Conclusion:The foundation of the connotation construction of the clinical skill center is to establish a complete, professional and gradient teaching team and a stepped clinical skills training curriculum system. The construction of a perfect internal quality control system is the vitality of the development of the clinical skill center, and scientific research is the source of the sustainable development of the center.

Traditional Chinese herbs (TCH) are currently gaining attention in disease prevention and health care plans. However, their general bitter taste hinders their use. Despite the development of a variety of taste evaluation methods, it is still a major challenge to establish a quantitative detection technique that is objective, authentic and sensitive. Based on the two-bottle preference test (TBP), we proposed a novel quantitative strategy using a standardized animal test and a unified quantitative benchmark. To reduce the difference of results, the methodology of TBP was optimized. The relationship between the concentration of quinine and animal preference index (PI) was obtained. Then the PI of TCH was measured through TBP, and bitterness results were converted into a unified numerical system using the relationship of concentration and PI. To verify the authenticity and sensitivity of quantified results, human sensory testing and electronic tongue testing were applied. The quantified results showed a good discrimination ability. For example, the bitterness of Coptidis Rhizoma was equal to 0.0579 mg/mL quinine, and Nelumbinis Folium was equal to 0.0001 mg/mL. The validation results proved that the new assessment method for TCH was objective and reliable. In conclusion, this study provides an option for the quantification of bitterness and the evaluation of taste masking effects.

Objective: To describe the clinical characteristics with long-term prognosis in patients with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM).
Methods: A total of 66 MVOHCM patients treated in our hospital were retrospectively studied for their morbidity, clinical characteristics and mortality. The cumulative survival rate was calculated by Kaplan-Meier method; the risk factors for cardiac death and cardiovascular events were analyzed by uni- and multivariate Cox proportional hazard model.
Results: There were 66 (2.74%) patients suffering from MVOHCM among 2413 patients of hypertrophic cardiomyopathy and the average diagnostic age was (40.16 ± 14.64) years. With (7.30 ± 6.25) years of follow-up study, the cardiovascular mortality was 13.6% and unexplained syncope (HR=13.37, 95% CI: 1.65-114.46, P=0.015) was the independent predictor for cardiovascular death. There were 45.45% (30/66) patients experienced at least 1 time of cardiovascular event and the most frequent one was non-sustained ventricular tachycardia (NSVT); 19.70% (13/66) of patients combined with apical aneurysms, and they were more inclined to experience NSVT.
Conclusion: MVOHCM patients usually have unfavorable prognosis with the higher incidence of cardiovascular events, some patients may develop apical aneurysm. The early diagnosis of MVOHCM is important for appropriate treatment.

Objective To investigate the expressions of NBS1 mRNA and protein in the salivary gland of irradiated rats and explore the role of NBS1 in the repair of radiation injury of salivary gland epithelial cells.Methods Eighty rats were randomly divided into two groups for radiation and control (n =40 each).The rats were fractionally exposed to 3 Gy of 60Co γ-rays once in two days,leading to an accumulation dose of 3,6,9,12,15 Gy.The sham-irradiated controls were anesthetized in parallel but without irradiation.After 2-4 h of irradiation,the rats were sacrificed,IHC and RT-PCR were used to detect the expressions of NBS1 protein and mRNA in parotid and submandibular glands,and the ultra-structural changes in the glands were observed by a transmission electron microscopy.Results After irradiation,the salivary glands became atrophy and the parotid gland cells were damaged more serious than the submandibular gland cells.Compared with the controls,with the groups of dose,at 9,12,15 Gy in parotid gland (t =7.10,17.93,20.86,P ＜ 0.05),at 12,15 Gy in the submandibular gland (t =3.13,7.53,P ＜0.05),the expression of NBS1 mRNA was reduced.With the groups of dose at 9,12,15 Gy in paretid gland (t =4.29,17.91,91.29,P ＜ 0.05 ),the dose at 12,15 Gy in submandibular gland ( t =4.61,11.84,P＜0.05),the expression of NBS1 protein in serous cells,and the dose at 12,15 Gy in parotid gland ductal epithelial cell ( t =3.09,5.62,P ＜ 0.05) were reduced.But in the ductal epithelial cells as well as muoass cells in the submandibualr gland were steadily.Conclusions After irradiation,NBS1 at both protein and mRNA levels was dropped in the salivary gland of rats,which might contribute to the repair of radiation injury of salivary gland.

Objective To evaluate the inhibition of urine 11-dH-TXB2 by dihydroxyaluminum aminoacetate-heavy magnesium carbonate-aspirin in Chinese cardiovascular patients after long-term therapy. Methods103 cardiovascular patients were treated with oral doses of dihydroxyaluminum aminoacetate-heavy magnesium carbonate-aspirin tablets (162 mg aspirin) daily for 24 weeks. The Urine 11-dH-TXB2 concentration were measured before and 6, 12, 24 weeks after administration. ResultsThe urine 11-dH-TXB2 concentration were （1840.41±1452.63） pg/ml, （820.01±610.55） pg/ml, （1011.19±1148.12） pg/ml, （1290.82±1425.51） pg/ml before and 6, 12, 24 weeks after administration. The urine 11-dh-TXB2 concentration was higher in 24th week than in 12th weeks and 6th week. ConclusionThe dihydroxyaluminum aminoacetate-heavy magnesium carbonate-aspirin can inhibit the platelet aggregation, which decreased after long-term administration.

Objective Dilated cardiomyopathy (DCM) is generally considered to be accompanied by both left and right ventricular dysfunction,but most studies only analyze the left ventricular function. In this study, we evaluated the effect of arotinolol on right ventricular function in patients with DCM. Methods Right ventricular ejection fraction (RVEF) and right ventricular diameter (RVD) were measured by two-dimensional echocardiography (2-DE) in 33 DCM patients; RVEF measured by first-pass radionuclide angiography (FPRA) was compared with that by 2-DE. Results The treatment with arotinolol for one year resulted in a reduction in the right ventricular diameter (baseline, 23.0 ± 8.3 mm vs after one-year treatment, 20.7 ± 5.4 mm; P=0.004 ) and an associated increase in ejection fraction (baseline, 36.9 ± 10.3% vs after one-year treatment, 45.8 ± 9.6%; P ＜ 0.001 ); there is a high correlation between the 2-DE method and radionuclide ventriculographic method. The correlation coefficient is 0.933 (P＜0.001). Conclusion Arotinolol therapy could not only improve left ventricular function, but also improve right ventricular function in DCM patients.

OBJECTIVETo investigate the changes in respiratory and circulatory functions in chronic obstructive pulmonary disease (COPD) patients during sequential invasive-noninvasive mechanical ventilation therapy, and evaluate the effects of this new technique.

METHODSTwelve COPD patients with type II respiratory failure due to severe pulmonary infection were ventilated through an endotracheal tube. When the pulmonary infection control window (PIC-Window) occurred, the patients were extubated and were ventilated with a facial mask using pressure support ventilation combined with positive end-expiratory pressure. The parameters of hemodynamics, oxygen dynamics, and esophageal pressure were measured at the PIC-Window during invasive mechanical ventilation, one hour after oxygen therapy via a naso-tube, and three hours after non-invasive mechanical ventilation.

RESULTSThe variation in esophageal pressure was 20.0 +/- 6 cmH(2)O during naso-tube oxygen therapy, and this variation was higher than that during non-invasive mechanical ventilation (10 +/- 6 cmH(2)O, P < 0.01). The changes in respiratory and circulatory parameters were not significantly different between invasive mechanical ventilation and noninvasive mechanical ventilation (P > 0.05).

CONCLUSIONSThe respiratory and circulatory functions of COPD patients remained stable during sequential invasive-noninvasive mechanical ventilation therapy using PIC-Window as a switch point for early extubation. The COPD patients can tolerated the transition from invasive mechanical ventilation to noninvasive mechanical ventilation.

Aged ; Blood Circulation ; physiology ; Female ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; therapy ; Respiration, Artificial ; methods ; Respiratory Physiological Phenomena

Objective To observe the somatic embryogenesis in in-vitro cultured Dendrobium candidum wall.Ex Lindl.(DCWL),and to supply evidence for its rapid propagation and germplasm preservation.Methods Protocorm-like bodies and callus of DCWL subcultured for 30 days was used as the explants,N6 was used as the basic culture with phytohormone added,and fungal extracts as the elicitor.Protocorm-like bodies and callus of DCWL were used for induction culture.Results Somatic embryogenesis in in-vitro cultured DCWL derived from the epithelial cells or inner cells of callus of DCWL.Conclusion A large amount of buds can be obtained by the induction and culture of protocorm-like bodies and callus of DCWL.

Objective　To investigate the effects of extrinsic positive end-expiratory pressure (PEEPe) on work of breathing in patients with chronic obstructive pulmonary disease (COPD) and their corresponding mechanism. Methods　Ten ventilated patients with COPD were included in the study. A Bicore CP-100 pulmonary monitor （Bicore Monitoring System, USA） was used for monitoring respiratory mechanics. First, dynamic intrinsic positive end-expiratory pressure (PEEPi,dyn) was measured when PEEPe was zero, which was called PEEPi,dynz. Then the PEEPe was set randomly at 0%, 40%, 60%, 80% and 100% of PEEPi,dynz respectively. Pulmonary mechanics and other parameters (heart rate, blood pressure and blood gas analysis) were measured 30 minutes after the level of PEEPe was changed. Results　Work of breathing patient (WOBp), pressure time product, difference of esophageal pressure and PEEPi,dyn decreased significantly when PEEPe was applied, and continued decreasing as PEEPe was increased. Work of breathing ventilator increased significantly when PEEPe was increased to 80% and 100% of PEEPi,dynz. Significantly positive linear correlation was found between the changes in WOBp and in PEEPi,dyn. Conclusions　WOBp decreases gradually as PEEPe is increased. WOBp decreases by narrowing the difference between the alveolus pressure and the central airway pressure at the end of expiration when PEEPe is applied.